A case of 41-year-old patient presented with left lower leg cellulitis, laboratory investigations showed elevated CK levels of more than 193000 U/L, high pancreatic enzymes level namely amylase & lipase, significant electrolyte and acid base abnormalities. Diagnosis of Rhabdomyolysis made based on CK level results in acute pancreatitis. This patient developed acute renal failure with all above in mind, he stayed inpatient for 19 days. The purpose of this case report is to highlight the unusually high CK with unusual association of acute pancreatitis leading to rhabdo¬myolysis and the associated morbidity.

The research aims to analyze and discover the weaknesses in regulations on criminal sanctions against perpetrators of criminal acts of corruption at this time, and the reconstruction of regulations on criminal sanctions against perpetrators of criminal acts of corruption based on the value of justice using a constructivism paradigm, through direct interviews with informants empirically supported with studies literature through theoretical steps. The research results show that the act of abuse of authority is a form or manifestation of an unlawful act regulated in Article 3 of Law Number 31 of 1999 jo. Law Number 20 of 2001. From the principles of legislative regulation, one of the reasons for the difference in criminal threats in Article 2 and Article 3 of Law Number 31 of 1999 Jo. Law Number 20 of 2001 is the principle of lex specialis derogat lex generalis (specific laws exclude general laws). The difference in the threat of minimum and maximum sentences in Article 2 and Article 3 of the Corruption Crime Law results in Judges imposing different sentences for the same case. Reconstruction of criminal sanctions against perpetrators of criminal acts of corruption based on the value of justice in Article 3 of the Corruption Eradication Law, namely: Every person who, with the aim of benefiting himself or another person or a corporation, abuses the authority, opportunity or means available to him because position or position that could harm state finances or the state economy, shall be punished with life imprisonment or imprisonment for a minimum of 5 (five) years and a maximum of 20 (twenty) years and/or a fine of at least Rp. 50,000,000,- (fifty million rupiah) and a maximum of Rp. 1,000,000,000,- (one billion rupiah).

The research aims to analyze and discover the weaknesses of the regulatory authority of Bhabinkamtibmas in resolving criminal acts through the community policing strategy to realize domestic security at this time and to reconstruct the authority of Bhabinkamtibmas in resolving criminal acts through community policing strategies to realize domestic security based on restorative justice values using a constructivism paradigm, through direct interviews with informants empirically supported with studies literature through theoretical steps. Research Result Show that the Reconstruction of the regulatory authority of Bhabinkamtibmas in resolving criminal acts through a community policing strategy in order to realize domestic security based on restorative justice values can be done by reconstructing Article 15 paragraph (1) letter b of Law Number 2 of 2002 concerning the Police of the Republic of Indonesia, Article 1 number 5, Article Article 3 paragraph (1), and Article 7 of the Regulation of the Head of the National Police of the Republic of Indonesia Number 7 of 2021 concerning Bhayangkara Building Security and Public Order, and Article 1 number 3 of the Regulation of the National Police of the Republic of Indonesia Number 1 of 2021 concerning Community Policing, which is related to the authority of Bhabinkamtibmas with a community policing strategy in resolving all forms of legal violations and other forms of disturbance that can disturb the community in a fair manner with a restorative and rehabilitative approach.

Health informatics systems are indispensable implements for cultivating the eminence and effectiveness of primary health care. Health informatics systems are formed of databases and figures regarding all clinical facilities. The utilization of health informatics systems helps both healthcare providers and patients in the management of disorders and disease risks and in developing well-being. However, there are a number of challenges to the application and practice of health informatics systems in the settings of primary health care. These challenges embrace; the absence of capital and money, the absence of technical skill, the absence of user recognition and approval, information quality problems, safety and confidentiality concerns, incorporation with other systems, and interoperability deficiency. Human, cultural, and financial barriers with deficiency of technical proficiency, deficiency of a relation between clinicians and patients, worries about information privacy, absence of administration guidelines, bureaucracy, lack of training, English language barrier, the degree of workload due to the time shortness during clinical settings, infrastructure concerns e.g. availability of the electricity, computers, and internet, also high turnover in IT among healthcare are also some challenges that should be addressed. These challenges can hold back the capacity of health informatics systems to comprehend their complete perspective in primary health care. To address these challenges, it is essential to provide sufficient capital and funds, offer practice and maintenance for users, overcome information quality concerns, apply safety and confidentiality procedures, incorporate health informatics systems with other systems, and endorse interoperability. By overcoming these challenges, health informatics systems can play a major role in developing the quality and efficiency of primary health care.

Background: Most women with a singleton pregnancy of cephalic presentation at 37+ weeks or later who have had a single prior lower segment cesarean delivery, with or without a history of prior vaginal birth, are candidates for planned VBAC and may be offered it for a trial of VBAC. Objective: The objective of this study is to determine the outcome of vaginal birth after caesarean section (VBAC) in a tertiary care hospital in Sylhet. Methods: This prospective study took place between April 2022 and February 2023 and lasted for a total of eleven months. A total of sixty patients were hospitalized in the gynecology and obstetrics department at North East Medical College, all of whom had a history of either one or two previous cesarean sections and were experiencing labor pain. 43 of these patients had their deliveries through the vaginal route. The remainder of the patients had cesarean sections because of fetal distress, scar tenderness, and the patient's wish during 1st stage of labor. Results: The VBAC success rate in this study was 71.67%. Among the 43 patients, the highest number of patients, 51.2%, came from the age range of 28-37 years, followed by 21 patients (48.8%), who were in the age category of 18-27 years. The majority of the patients (24, 55.82%) were in their second pregnancy, with 10 (23.25%) in their third pregnancy and 9 (20.93%) in their more than third pregnancy. Among the 43 patients, 42 (97.7%) had a previous caesarean section, while the remaining 1 patient (2.3%) had two previous caesarean sections. Most patients (58.14%) were admitted to the hospital between 35 and 38 weeks of pregnancy. Among the participants, 97.7% had normal placenta size, 88.4% had average bleeding, 79.1% had clear liquor and 97.7% had no scar rapture. The study shows an extremely low level of complication in VBAC. Conclusion: This study identified that, the success rate of vaginal birth after one caesarean section is very high. An evidence-based systematic review suggested that planned VBAC is a safe and appropriate mode of delivery for the majority of pregnant women with a single previous lower-segment caesarean delivery.

Bronchial Asthma is a chronic inflammatory disorder of respiratory airways that affects loads of children worldwide. It is characterized by tightening of respiratory airways, making it hard to breathe. There is no curing treatment for asthma, but its management using medication and routine modifications can be achieved. The use of online information for bronchial asthma control was recently introduced and markedly being an emergent trend of parents to manage their asthmatic children. This research discovers the probable advantages and disadvantages of using online health information for asthma management in children. This work found that online health data can be a significant resource for parents of asthmatic children. It can offer correct information about the status of the patient, therapy choices, and lifestyle modifications that can aid to control manifestations. Online health data can also support parents' connection with other parents of asthmatic children and to discover support groups. However, the study also detected that there are some disadvantages related to the use of online health information in asthma pediatric patients. Parents may be exposed to incorrect or confusing data, and they may not be able to discriminate between dependable and untrustworthy sources. Moreover, parents may depend on online information and disregard consulting with their child's physician. Generally, this work proposes that online health data can be a useful method for parents of children with asthma. Though, it is vital to use this information in a wise way and keep consulting child's physician before choosing to make any modifications to a child's treatment strategy.

Hiccups are most often benign and short-lived, but they can also be persistent (> 48h) or even refractory (> 1 month). In these cases, it impairs qualitý of life and can have serious health consequences. We report the case of a patient who consulted for chronic hiccups with absences and in whom the neurological origin was confirmed on brain MRI.

The present study aimed at A study to assess the effectiveness of back massage with Olive oil for pain relief among antenatal women during first stage of labor at Sangareddy, hospital, Ts. A quantitative evaluative research approach was used for this study. The conceptual framework used for this study was Modified Ludwig and Bertalanffy, general system theory. Random sampling technique was used to select the antenatal mother. Structured questionnaire was used to collect demographic data and Pretest and posttest pain assessment was done by using numeric pain rating scale. The discussion of the present study is based on the findings obtained from descriptive and inferential statistical analysis of collected data."

This research aims to determine the impact of financial literacy, financial behavior, and quality of learning accounting on consumptive behavior (a case study of accounting students at private universities in Jakarta). The demographic and samples for this study were from Jakarta Private Higher Education Accounting Students, wherein determining the sample, the method used was saturated sampling. The analytical method in this study uses statistical methods assisted by the SmartPLS version 3.0 program. This study's results indicate that financial behavior and the quality of learning accounting have a significant positive effect on consumptive behavior (Case Study on Accounting Students at Private Higher Education Jakarta). In contrast, financial literacy has no significant positive effect on consumptive behavior (Case Study on College Accounting Students Jakarta Private College).

Polycystic ovarian syndrome is a common cause of ovarian dysfunction in women with anovulation world wide.50-70% of patients with PCOS exhibit metabolic abnormalities, including poor glucose tolerance and hyperinsulinemia. The prevalence of vitamin D deficiency in women with PCOS is about 67-85 per cent, with serum concentrations of 25(OH) D <20 ng/ml. It is suggested that there is an association between serum levels of vitamin D and metabolic parameters in women with PCOS, including fasting glucose levels, fasting insulin, insulin resistance, high blood pressure, lipid disorders, obesity, fertility and other clinical and laboratory- related parameters associated with PCOS. Given the high prevalence of vitamin D deficiency in the south Indian population, less number of studies, inconclusive studies, especially in the population of women with PCOS, as well as evidence from recent studies indicating a link between vitamin D levels with lab parameters, this study aimed to assess the relationship between vitamin D deficiency and insulin resistance in PCOS. Pearsons correlation showed 0.034 between HOMA IR and vitamin d levels indicating that vitamin d deficiency is associated with more HOMA IR values, the more insulin resistance. Pearsons correlation showed 0.05 between fasting insulin levels and vitamin d levels indicating the vitamin d deficiency is associated with more fasting insulin levels, the more insulin resistance. No significant relation is seen with fasting glucose insulin levels (Pearsons correlation value >0.05). In the study, it was found that a high percentage of PCOS women were vitamin D deficient. The study also showed a significant difference in the values of some clinical and metabolic parameters such as waist circumference, fasting insulin, HOMA-IR, BMI between PCOS women with and without vitamin D deficiency; however, no linear correlation was found between serum levels of vitamin D and baseline variables, except for HOMA IR values, fasting insulin levels, BMI, G120. In conclusion, our data confirm an association between vitamin D deficiency and Insulin resistance in patients with PCOS. Thus, vitamin D supplementation could be a beneficial treatment of PCOS women to abolish insulin resistance and regulate menstrual irregularities.

This work aims to evaluate the antimicrobial potential of halophytic plant, Sesuvium portulacastrum (L.) against, some plant and human pathogens. Plant parts of S. portulacastrum were collected from the mangrove habitats of Coringa Reserve Forest near Kakinada, Andhra Pradesh, India. Plant parts are dried and extracts were obtained successfully with hexane, chloroform, methanol and water, using Soxhlet extraction apparatus. Agar well diffusion method has been used to determine the antimicrobial activity of plant extracts against some gram positive bacteria (Bacillus subtilis, Bacillus megaterium and Lactobacillus acidophilus), gram negative bacteria (Escherichia coli, Enterobacter aerogenes, Enterobacter cloace and Klebsiella pneumonia) and fungal species (Candida albicans, Mucar recemosus, Rhizoctonia solani, Rhizopus stolonifer and Saccharomyces cerevisiae). The hexane, chloroform extracts showed minimum antimicrobial activity when compared to methanolic and water extracts. Water extract of S. portulacastrum showed appreciable antimicrobial activity against all bacterial and fungal strains. It reveals that this halophytic species has antimicrobial compounds which can act against microorganisms and they can be used in the treatment of infectious diseases caused by pathogenic microorganisms.

Epilepsy is one of the chronic neurological conditions affecting people of all ages globally. Educational progress have been affected negatively by some abnormalities associated with epilepsy. This study employed neurobehavioural analysis of pentylenetetrazole (PTZ) induced seizure on some visual spatial functions in Wistar rats. The study was done in two phases: acute (14days) and chronic (28days). A total of twenty adult Wistar rats weighing between 90-120g were used. The rats were divided into four (4) groups (1-4, n=5). PTZ was administered intraperitoneally to the PTZ treated groups one (1) week before the neurobehavioral experiments commenced. Group 1 (control) received distilled water, group 2, 3and 4 were administered with doses of PTZ (25mg/kg, 30mg/kg and 35mg/kg) respectively at alternate days (48 hourly) until kindling was achieved. The study evaluated neurobehavioural parameters using Barnes maze (BM), navigational box test (NBT). The results from neurobehavioural evaluations on effects of the chemo-convulsant seizures on visual spatial functions, suggests that severity of seizures caused a deficit in learning and visual spatial memory which was worsened by chronicity. In conclusion, PTZ-induced seizure negatively interferes with visual spatial functions.

Klebsiella pneumonia is an opportunistic pathogen causes several diseases including sepsis, pneumonia, and wound infections. There are two pathotypes of Klebsiella pneumonia: classical K. pneumoniae (cKp) and hypervirulent K. pneumonia (hvkp), which is an emerging variant of (ckp), clinically distinguished by invasive and multiple site infections. K.pneumoniae is also responsible for majority of human infections, and can infected healthy members of the community and hospitalized patients. A total 150 samples were collected from different hospitals in Kirkuk city during the period between November 2021 to June 2022. The age of patients ranged between (1– 60) years old with both sexes. These samples were highly recovered from females with a rate 66.67% compared to the males 33.33%. Thirty K. pneumonia (20%) was recovered from different clinical specimens including urine, sputum, burn and wound swabs. The current study reported that females are more likely to be infected with K. pneumoniae than man. Likewise, the most common age group infected with K.pneumoniae was between (20-40) with a rate of 63.33%. K.pneumoniae was commonly recovered from inpatients 53.33% compared with outpatients (46.67%). Antibiotic susceptibility test was conducted to all the isolates by using disc diffusion test towards 8 antimicrobial agents. Klebsiella pneumoniae isolates showed multiple resistance against 3 or more of different antibiotic groups such as gentamicin 93%, ampicillin 96% and amoxicillin –clavulanate 90%, cefotaxime 83%, ceftazidime 96%, meropenem 36%, levofloxacin 76 %and gentamicin 93 %. K. pneumoniae isolated from inpatients and from sputum samples were more resistance to various kinds of antibiotics.

Background: Realizing the advantages of lifestyle modification after myocardial infarction (MI) requires active lifestyle change. Sometimes patients find it difficult to follow the recommendations for lifestyle changes, which are crucial for all MI patients to implement in order to lower the risk of secondary attack. This study aimed to explore the real-world experiences of post MI patients who had changed their lifestyles at a university hospital. Methods: This qualitative study was conducted among 20 purposively selected post MI patients. The patients who had confirmed medical diagnosis as old MI, had admitted in Bangabandhu Sheikh Mujib Medical University Hospital for more than a week, and had willingness to take participation in this study, were considered as the study subjects. Data was collected through an open ended semi-structured questionnaire by face to face interview. Using qualitative content analysis, the interview transcripts were examined at the same time as the data was being gathered. Results: Out of 20 study subjects, 55% were male and 60% were Muslim. Participants age was ranging from 36-70 years. Two themes namely adjustment with modified life and mal-adjustment with normal life were emerged as the lived experiences on lifestyle modification of patients with old Myocardial Infarction. Conclusion: It is concluded that patients with post-MI can have both good and bad experiences during the period of lifestyle modification.

Background: Ferritin is a soluble protein which provides intracellular storage of bioavailable iron. It is found primarily in Liver, bone marrow macrophages, spleen. Ferritin is measured by ELISA, RIA and Mass spectrometry. The main aim of this study is to etiologically categorise extreme hyperferritinemia (serum ferritin > 10000 microg/L). Methodology and Results: This is 05 years retrospective study (July -2018 to June 2023), conducted in hematology section, MMCH, KSA. Out of 34 cases of extreme hyperferritinemia, viral infection was the most common cause comprising 41% of all cases. Amongst the infectious etiology, 6 cases of EBV, 3 cases of ALF of suspected viral etiology, 2 cases of PIDS with secondary infection, 1 case each of Hepatitis A virus and CMV noted. 10 cases presented as Macrophage Activating syndrome comprising 29% of total cases of which 70 were Systemic Juvenile Idiopathic arthritis and remaining 30% includes SLE and juvenile rheumatoid arthritis. Discussion: Study conducted by Dondu et al., indicate that the most common causes of hyperferritinemia are rheumatologic diseases and infections, which were identified in 59.1 and 27.3%, respectively. Present study showed infective etiology as the most common cause of extreme hyperferritinemia. Reasons for differences in results are because other studies were conducted in Adult patients and in Rheumatologic department. Conclusion: Our study formulated a systematic investigating pathway for raised serum ferritin. If the laboratory screening tests, BMA and other sophisticated tests are done in systematic way, then challenging cases can be diagnosed easily.